Oral health assessment and care practices in long-term care: a convergent mixed methods study

Poor oral health in long-term care (LTC) impacts residents' nutrition, systemic health, and quality of life. LTC residents are often living with cognitive decline and functional limitations, hindering daily oral hygiene and limiting access to professional oral care services. This mixed-methods study investigated oral health assessment and care practices in an Atlantic Canadian LTC facility and the care team's perception of a dental hygienist's role in LTC.

Data were collected through semi-structured interviews and focus groups with residents, unpaid caregivers, and nursing and care staff, as well as through a retrospective chart review to explore oral health practices and their documentation. Qualitative and quantitative data underwent thematic and descriptive statistical analysis, respectively.

Between June 2023 and March 2024, 35 paid caregivers, 6 residents, and 1 unpaid caregiver were interviewed, and 14 charts were reviewed. Findings reveal complex factors influencing oral health, including perceptions of inadequacy, cultural attitudes, challenges in implementing consistent care due to staff shortages and residents' responsiveness to oral care, and the critical role of the dental hygienist.

The results highlight the need to integrate oral health professionals into LTC facilities and emphasize the importance of person-centred approaches to oral care to improve oral health practices and ultimately enhance residents' quality of life.